Medical Inquiries and Observations, Vol. 4: The Second Edition, Revised and Enlarged by the AuthorRush, Benjamin
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Medical Inquiries and Observations, Vol. 4: The Second Edition, Revised and Enlarged by the Author
Rush, Benjamin
Medicine; Yellow fever -- Pennsylvania -- Philadelphia
VII. Regard should be had to the age of adults in prescribing bleeding.
In persons between fifty and sixty years of age, for reasons formerly
mentioned, more blood may be drawn than in middle life, in similar
diseases. In persons beyond 70, it will be necessary to regulate the
quantity to be drawn by other signs than the pulse, or the appearances of
the blood, the former being generally full, and sometimes tense, and the
latter often putting on the sign of the second grade of morbid action
formerly described.
VIII. Regard should be had to the country or place from which persons
affected with fevers have arrived, in prescribing the loss of blood.
Fevers, in America, are more inflammatory than fevers, in persons of
equal rank, in Great-Britain. A French physician once said, it was safer
to draw a hogs-head of wine from a Frenchman's veins, than a quarter of a
hundred pounds of beef from an Englishman's, meaning to convey an idea of
the difference in the grades of morbid or inflammatory action in the
diseases of the inhabitants of France and England, and of the difference
in the quantity of blood proper to be drawn in each of them. A similar
difference exists between the grades of fever in Great-Britain and
America. From a want of attention to this circumstance, I saw a common
pleurisy end in an abscess of the lungs, in a sea captain, in the city of
London, in the year 1769, who was attended by a physician of the first
reputation in England. He was bled but once. His pulse and American
constitution called for the loss of 50 or 60 ounces of blood.
IX. Regard should be had to the structure and situation of the parts
diseased with febrile action. The brain, from its importance to all the
functions of life, the rectum, the bladder, and the trachea, when
inflamed, and the intestines, when strangulated, from their being removed
so much out of the influence of the great circulation, all require more
copious bleeding than the same degrees of disease in the lungs, and some
other parts of the body.
X. After blood-letting has been performed, the appearances of the blood
should be attended to, in order to judge of the propriety of repeating
it. I shall briefly describe these appearances, and arrange them in the
order in which they indicate the different degrees of inflammatory
diathesis, beginning with the highest.
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